Standardization of lateral pelvic radiograph is necessary to predict spinopelvic mobility accurately

2020 ◽  
Vol 102-B (7_Supple_B) ◽  
pp. 41-46 ◽  
Author(s):  
Michael Ransone ◽  
Keith Fehring ◽  
Thomas Fehring
Keyword(s):  
Pelvic Tilt ◽  
Preoperative Planning ◽  
Sacral Slope ◽  
Sitting Posture ◽  
Sit To Stand ◽  
Pelvic Radiograph ◽  
Increased Risk ◽  
Anterior Pelvic Tilt ◽  
B 41 ◽  
The Mean

Aims Patients with abnormal spinopelvic mobility are at increased risk for instability. Measuring the change in sacral slope (ΔSS) can help determine spinopelvic mobility preoperatively. Sacral slope (SS) should decrease at least 10° to demonstrate adequate posterior pelvic tilt. There is potential for different ΔSS measurements in the same patient based on sitting posture. The purpose of this study was to determine the effect of sitting posture on the ΔSS in patients undergoing total hip arthroplasty (THA). Methods In total, 51 patients undergoing THA were reviewed to quantify the variability in preoperative spinopelvic mobility when measuring two different sitting positions using SS for planning. Results A total of 32 patients had standardized relaxed sitting radiographs, while 35 patients had standardized flexed sitting images. Of the 32 patients with relaxed sitting views, the mean ΔSS was 20.7° (SD 8.9°). No patients exhibited an increase in SS during relaxed sitting (i.e. anterior pelvic tilt or so-called reverse accommodation). Of the 35 patients with flexed sitting radiographs, the mean ΔSS was only 2.1° (SD 9.7°) with 16/35 (45.71%) showing anterior pelvic tilt, or so-called reverse accommodation, unexpectedly increasing the sitting SS compared to the standing SS. Overall, 18 patients had both relaxed sitting and flexed sitting radiographs. In patients with both types of sitting radiographs, the mean relaxed sit to stand ΔSS was 18.06° (SD 6.07°), while only a 3.00° (SD 10.53°) ΔSS was noted when flexed sitting. There was a mean ΔSS difference of 15.06° (SD 7.67°) noted in the same patient cohort depending on sitting posture (p < 0.001). Conclusion A 15° mean difference was noted depending on the sitting posture of the patient. Since decisions on component position can be made on preoperative lateral sit-stand radiographs, postural standardization is crucial. If using ΔSS for preoperative planning, the relaxed sitting radiograph is preferred. Cite this article: Bone Joint J 2020;102-B(7 Supple B):41–46.

scholarly journals Postoperative changes in sagittal spinopelvic alignment in sitting position in adolescents with idiopathic thoracic scoliosis treated with posterior fusion: an initial analysis

2018 ◽  
Vol 22 (1) ◽  
pp. 74-80 ◽  
Author(s):  
Weiguo Zhu ◽  
Zhen Liu ◽  
Shifu Sha ◽  
Jing Guo ◽  
Hongda Bao ◽  
...  
Keyword(s):  
Spinal Fusion ◽  
Posterior Spinal Fusion ◽  
Posterior Fusion ◽  
Sacral Slope ◽  
Sitting Position ◽  
Fusion Surgery ◽  
Sitting Posture ◽  
Spinopelvic Alignment ◽  
Postoperative Changes ◽  
The Mean

OBJECTIVEPrevious studies have reported spinal straightening and pelvic retroversion when changing from erect to sitting posture in patients with adolescent idiopathic scoliosis (AIS), which were thought to be related to low-back pain after sitting for long periods. However, the sitting sagittal alignment after posterior spinal fusion has not been evaluated. This study aims to assess the influence of posterior fusion surgery upon sitting sagittal spinopelvic alignment in adolescents with idiopathic thoracic curves (thoracic AIS [T-AIS]).METHODSA total of 44 T-AIS patients (30 Lenke I and 14 Lenke II) from the authors’ center were included in this study. Preoperative and postoperative long-cassette lateral radiographs of the spine and pelvis were obtained with the patients in standing and sitting positions. Thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) were measured on standing and sitting lateral radiographs. Patients were divided into selective thoracic fusion (STF) and nonselective thoracic fusion (NSTF) groups.RESULTSAt baseline, TK, LL, and SS decreased by 27.5%, 42.1%, and 31.1%, respectively, from the standing to the sitting position, while PT increased by 193.6%. After posterior spinal fusion, increased TK, LL, and SS and corresponding decreased PT were observed compared to baseline parameters in the sitting position. Comparison of postoperative sitting and standing values for the whole cohort showed that the mean LS and SS values were significantly lower in the sitting position (decreased by 14.0% and 13.9%, respectively, compared to standing), whereas the mean PT value was significantly greater (increased by 39.0%, compared to standing). Similar changes were also observed in the STF group: postoperatively the mean LL value was 15.6% lower in sitting than in standing, while the mean SS value was 11.5% lower. However, no obvious changes of the postoperative values in sitting were found in the NSTF group.CONCLUSIONSNonselective thoracic fusion surgery in T-AIS patients diminished spinal straightening and pelvic retroversion during sitting. Reducing distal fusion levels was of special value in not only saving more lumbar mobility, but also preserving the function of pelvic posterior rotation.

scholarly journals Distal Femoral Shortening Osteotomy for Severe Knee Flexion Contracture and Crouch Gait in Cerebral Palsy

2019 ◽  
Vol 8 (9) ◽  
pp. 1354 ◽  
Author(s):  
Hoon Park ◽  
Byoung Kyu Park ◽  
Kun-Bo Park ◽  
Sharkawy Wagih Abdel-Baki ◽  
Isaac Rhee ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Pelvic Tilt ◽  
Flexion Contracture ◽  
Knee Flexion Contracture ◽  
Shortening Osteotomy ◽  
Femoral Shortening ◽  
Crouch Gait ◽  
Anterior Pelvic Tilt ◽  
The Mean

Although there have been advancements of surgical techniques to correct gait abnormalities seen in patients with cerebral palsy, the crouch gait remains one of the most difficult problems to treat. The purpose of this retrospective study was to examine our results of distal femoral shortening osteotomy (DFSO) and patellar tendon advancement (PTA), performed in patients with crouch gait associated with severe knee flexion contracture. A total of 33 patients with a mean fixed knee contracture of 38° were included in the study. The mean age at the time of surgery was 12.2 years and the mean follow-up was 26.9 months. The measurements of clinical, radiological, and gait parameters were performed before and after surgery. The mean degrees of knee flexion contracture, Koshino index of patella height, and Gait Deviation Index were found to be significantly improved at the time of final follow-up. The maximum knee extension during the stance phase improved by an average of 25°, and the range of knee motion during gait increased postoperatively. On the other hand, the mean anterior pelvic tilt increased by 9.9°. Also, the maximum knee flexion during the swing phase decreased and the timing of peak knee flexion was observed to be delayed. We conclude that combined procedure of DFSO and PTA is an effective and safe surgical method for treating severe knee flexion contracture and crouch gait. However, the surgeons should be aware of the development of increased anterior pelvic tilt and stiff knee gait after the index operation.

A cluster-controlled clinical trial of two prophylactic silicone sacral dressings to prevent sacral pressure injuries in critically ill patients

2019 ◽  
pp. 21-26 ◽  
Author(s):  
Monica Stankiewicz ◽  
Jodie Gordon ◽  
Joel Dulhunty ◽  
Wendy Brown ◽  
Hamish Pollock ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Intensive Care ◽  
Similar Efficacy ◽  
Care Patient ◽  
Controlled Clinical Trial ◽  
Cost Difference ◽  
Increased Risk ◽  
Pressure Injury ◽  
Risk Patients ◽  
The Mean

Objective Patients in the intensive care unit (ICU) have increased risk of pressure injury (PI) development due to critical illness. This study compared two silicone dressings used in the Australian ICU setting for sacral PI prevention. Design A cluster-controlled clinical trial of two sacral dressings with four alternating periods of three months' duration. Setting A 10-bed general adult ICU in outer-metropolitan Brisbane, Queensland, Australia. Participants Adult participants who did not have a sacral PI present on ICU admission and were able to have a dressing applied for more than 24 hours without repeated dislodgement or soiling in a 24-hour period (>3 times). Interventions Dressing 1 (Allevyn Gentle Border Sacrum™, Smith & Nephew) and Dressing 2 (Mepilex Border Sacrum™, Mölnlycke). Main outcomes measures The primary outcome was the incidence of a new sacral PI (stage 1 or greater) per 100 dressing days in the ICU. Secondary outcomes were the mean number of dressings per patient, the cost difference of dressings to prevent a sacral PI and product integrity. Results There was no difference in the incidence of a new sacral PI (0.44 per 100 dressing days for both products, p = 1.00), the mean number of dressings per patient per day (0.50 for both products, p = 0.51) and product integrity (85% for Dressing 1 and 84% for Dressing 2, p = 0.69). There was a dressing cost difference per patient (A$10.29 for Dressing 1 and A$28.84 for Dressing 2, p < 0.001). Conclusions Similar efficacy, product use and product integrity, but differential cost, were observed for two prophylactic silicone dressings in the prevention of PIs in the intensive care patient. We recommend the use of sacral prophylactic dressings for at-risk patients, with the choice of product based on ease of application, clinician preference and overall cost-effectiveness of the dressing.

Airway management with I-gelTM for ambulatory laparoscopic inguinal hernia repair in children; a retrospective review of 230 cases

2020 ◽  
Vol 24 (5) ◽  
Author(s):  
Carla Hipólito ◽  
Vicente Vieira ◽  
Virginia Antunes ◽  
Petra Alves ◽  
Adriana Rodrigues ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Airway Management ◽  
Inguinal Hernia Repair ◽  
Neuromuscular Blockade ◽  
Retrospective Review ◽  
Laparoscopic Inguinal Hernia Repair ◽  
Laparoscopic Inguinal Hernia ◽  
Increased Risk ◽  
The Mean

Background: Inguinal hernia is one of the most common conditions presented for surgical repair in children and laparoscopic approaches are increasingly performed. Previous studies have shown safety and efficacy in the use of supraglottic devices (SGD) as an alternative to tracheal intubation, which fits particularly well with outpatient anesthesia. Methodology: we conduct a retrospective observational study, collecting data from the electronic anesthetic form, from all patients aged 0 to 17 y who underwent ambulatory laparoscopic percutaneous internal ring suturing between February 2015 and August 2019, if I-gelTM was used to airway management. Results: We found 230 patients meeting the inclusion criteria. The mean age was 5.2 y old, mean weight 20.1 kg. All patients were ASA I (n=203) or ASA II (n=27). The mean surgery duration was 38 minutes. We found 4 respiratory adverse events, three bronchospasms, and one laryngospasm, managed in the operating room. Ninety percent of the surgeries were performed without neuromuscular blockade. Conclusion: I-gelTM was a safe, effective, and convenient alternative to airway management to laparoscopic inguinal hernia repair in the ambulatory setting. According to available literature, our practice did not represent an increased risk for the studied respiratory events. SGD obviates the need for neuromuscular blockade. Key words: I-gel; Supraglottic devices; Laparoscopy; Inguinal hernia repair; Pediatrics; Anesthesia, ambulatory Citation: Hipólito C, Vieira V, Antunes V, Alves P, Rodrigues A, Santos MJ. Airway management with I-gelTM for ambulatory laparoscopic inguinal hernia repair in children; a retrospective review of 230 cases. Anaesth. pain intensive care 2020;24(5): Received: 18 February 2020, Reviewed: 5 August, 6 September 2020, Accepted: 11 September 2020

Robotic-Assisted Patellofemoral Replacement—Correlation of Preoperative Planning with Intraoperative Implant Position and Early Clinical Experience: A Minimum 2-Year Follow-up

2020 ◽  
Author(s):  
Veenesh Selvaratnam ◽  
Andrew Cattell ◽  
Keith S. Eyres ◽  
Andrew D. Toms ◽  
Jonathan R. P. Phillips ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Preoperative Planning ◽  
Trochlear Dysplasia ◽  
Oxford Knee Score ◽  
Implant Position ◽  
Robotic Assisted ◽  
Implant Positioning ◽  
Flexion Extension ◽  
The Mean

AbstractPatello-femoral arthroplasty (PFA) is successful in a selected group of patients and yields a good functional outcome. Robotic-assisted knee arthroplasty has been shown to provide better implant positioning and alignment. We aim to report our early outcomes and to compare Mako's (Robotic Arm Interactive Orthopaedic System [RIO]) preoperative implant planning position to our intraoperative PFA implant position. Data for this study was prospectively collected for 23 (two bilateral) patients who underwent robotic-assisted PFA between April 2017 and May 2018. All preoperative implant position planning and postoperative actual implant position were recorded. Presence of trochlear dysplasia and functional outcome scores were also collected. There were 17 (two bilateral) female and 6 male patients with a mean age of 66.5 (range: 41–89) years. The mean follow-up period was 30 (range: 24–37) months. Eighteen knees (72%) had evidence of trochlear dysplasia. The anterior trochlear line was on average, 7.71 (range: 3.3–11.3) degrees, internally rotated to the surgical transepicondylar axis and on average 2.9 (range: 0.2–6.5) degrees internally rotated to the posterior condylar line. The preoperative planning range was 4-degree internal to 4-degree external rotation, 4-degree varus to 6-degree valgus, and 7-degree flexion to 3-degree extension. The average difference between preoperative planning and intraoperative implant position was 0.43 degrees for rotation (r = 0.93), 0.99 degrees for varus/valgus (r = 0.29), 1.26 degrees for flexion/extension (r = 0.83), and 0.34 mm for proudness (r = 0.80). Six patients (24%) had a different size component from their preoperative plan (r = 0.98). The mean preoperative Oxford Knee Score (OKS) was 16 and the mean postoperative OKS was 42. No patient had implant-related revision surgery or any radiological evidence of implant loosening at final follow-up. Our early results of robotic PFA are promising. Preoperative Mako planning correlates closely with intraoperative implant positioning. Longer follow-up is needed to assess long-term patient outcomes and implant survivorship.

Elevation of pulse pressure in middle age is associated with the risk of dementia: data from a population-based cohort

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Kim ◽  
H Jung ◽  
P.S Yang ◽  
H.T Yu ◽  
T.H Kim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pulse Pressure ◽  
Middle Age ◽  
Population Based ◽  
Entire Cohort ◽  
Incident Dementia ◽  
Increased Risk ◽  
Diagnosis Of Dementia ◽  
History Of ◽  
The Mean

Abstract Aims Pulse pressure (PP) is a well-known risk factor for cardiovascular disease. However, the association between the PP and dementia is not well identified. This study aimed to determine the effect of PP on the risk of dementia development in different age subgroups using a longitudinal, population-based, and stroke-free cohort from the general population. Methods The association of PP with the development of incident dementia was assessed from January 1, 2005, to December 31, 2013, in 433,154 participants without a history of dementia or stroke from the Korea National Health Insurance Service-Health Screening cohort. The diagnosis of dementia was defined using the 10th revision of the International Classification of Disease codes. Results The mean age of the cohort was 55.7±9.2 years, 45.7% were women. Hypertension was 23.6%. The mean systolic and diastolic blood pressure of the entire cohort were 125.9±16.6 and 78.4±10.7 mmHg, respectively. Mean PP was 47.5±10.9 mmHg. In the middle-age group (40 to 50 year-old), increasing of 10 mmHg of PP was associated with incident dementia after adjusting mean blood pressure and clinical variables with a hazard ratio (HR) of 1.21 (95% confidence interval [CI]: 1.19–1.23, p&lt;0.001). The association was still significant even after censoring for stroke (HR: 1.16, 95% CI: 1.08–1.22, p&lt;0.001). In the older population, elevation of PP was not associated with dementia development (HR: 0.98, 95% CI: 0.95–1.01, p=0.247) Conclusion PP was associated with increased risk of dementia only in middle-aged population beyond that of mean arterial pressure. Funding Acknowledgement Type of funding source: None

scholarly journals OP0073 RISK OF DEVELOPING RHEUMATIC DISEASES IN PATIENTS WITH PALINDROMIC RHEUMATISM IN SOUTH KOREA: A NATION-WIDE POPULATION-BASED STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 49.2-49
Author(s):  
J. K. Ahn ◽  
J. Hwang ◽  
J. Lee ◽  
H. Kim ◽  
G. H. Seo
Keyword(s):  
Health Insurance ◽  
South Korea ◽  
Rheumatic Diseases ◽  
Index Date ◽  
Claims Data ◽  
Population Based ◽  
Palindromic Rheumatism ◽  
Psoriatic Arthropathy ◽  
Increased Risk ◽  
The Mean

Background:Palindromic rheumatism (PR) has known to be three patterns of disease course: clinical remission of attacks, persistent attacks, and evolution to chronic arthritis or systemic disease. The spectrum in progression to chronic diseases of PR, however, is quite variable; rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc), Sjögren’s syndrome (SjS), ankylosing spondylitis (AS), relapsing polychondritis (RP), Behçet’s disease (BD), sarcoidosis, and psoriatic spondylitis and arthropathy. Because of the small numbers in case-control studies and too aged investigations, now we needs to shed new light on the fate of PR.Objectives:The aim was to investigate the epidemiology of PR and the risk of developing various rheumatic diseases compared with non-PR individuals, employing the National Health Insurance Service (NHIS) medical claims data, which covers all medical institutions of South Korea.Methods:The study used 2007-2018 claims data from the Korean Health Insurance Review and Assessment Service (HIRA). The identified 19,724 PR patients from 2010 to 2016 were assessed for the incidence rate (IR) compared with the population in the given year by 100,000 person-year (py). The date of diagnosis was the index date. After matching with non-PR individuals (1:10) for age, sex and the year of index date, we calculated the hazard ratios (HRs) with 95% confidence intervals (CIs). The risk of developing the various rheumatic diseases and adult immunodeficiency syndrome (AIDS) as the outcome diseases in PR cohort was estimated. This risk was compared with that of matched non-PR cohort.Results:Of 19,724 PR patients (8,665 males and 11,059 females), the mean age was 50.2 ± 14.9 years (47.7 ± 14.4 years in males and 52.6 ± 14.9 years in females,p< 0.001). The ratio of male to female patients with PR was approximately 1:1.28. The annual IR of PR was 7.02 (6.92-7.12) per 100,000 py (6.22 (6.09-6.35) and 7.80 (7.66-7.95) per 100,000 py in males and females, respectively). The mean duration to develop the outcome diseases was significantly shorter in PR cohort compared that of non-PR cohort (19.4 vs. 35.8 months,p< 0.001). The most common outcome disease was RA (7.34% of PR patients; 80.0% of total outcome diseases), followed by AS, SLE, BD, SjS, MCTD, DM/PM, SSc, RP, psoriatic arthropathy, and AIDS in PR cohort. The patients with PR had an increased risk of RA (HR 46.6, 95% CI [41.1-52.7]), psoriatic arthropathy (44.79 [15.2-132.4]), SLE (24.5 [16.2-37.2]), MCTD (22.0 [7.7-63.3]), BD (21.0 [13.8-32.1]), SjS (12.4 [8.5-17.9]), AS (9.0 [6.7-12.2]), DM/PM (6.1 [2.6-14.8]), and SSc (3.8 [1.5-9.6]) but not of AIDS. The risk of developing RA was greater in male patients (HR 58.9, 95% CI [45.6-76.2] vs. 43.2 [37.4-49.8],pfor interaction = 0.037) while female patients encountered a higher risk of developing AS (15.8 [8.9-28.1] vs. 7.2 [5.0-10.3],pfor interaction = 0.023). The risk of developing RA, SLE, SjS, and BD were significantly more highly affected in younger age (pfor interaction < 0.001, = 0.003, 0.002, and 0.017, at each).Conclusion:This nationwide, population-based cohort study demonstrated that patients with PR had an increased risk of developing various rheumatic diseases, not only RA but also psoriatic arthropathy. Therefore, patients with PR needs to be cautiously followed up for their potential of diverse outcome other than RA: RA, SLE, SjS, and BD in younger patients, RA in males, and AS in females, in particular.Disclosure of Interests:None declared

The effect of insulin pump therapy in retinal vasculature in type 1 diabetic patients

2021 ◽  
pp. 112067212199057
Author(s):  
Tomás de Oliveira Loureiro ◽  
João Nobre Cardoso ◽  
Carlos Diogo Pinheiro Lima Lopes ◽  
Ana Rita Carreira ◽  
Sandra Rodrigues-Barros ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Metabolic Control ◽  
Insulin Pump Therapy ◽  
Vascular Density ◽  
Diabetic Patients ◽  
Retinal Vasculature ◽  
Increased Risk ◽  
The Mean ◽  
Type 1 Diabetic Patients

Background/objectives: Continuous subcutaneous insulin infusion (CSII) is a treatment for type 1 diabetes that improves metabolic control and reduces micro and macrovascular complications. The aim of this study was to compare the effect of CSII versus traditional multiple daily injections (MDI) therapy on retinal vasculature. Methods: We performed a prospective study with type 1 diabetic patients with no prior history of ocular pathology other than mild diabetic retinopathy. The patients were divided into two groups according to their therapeutic modality (CSII vs MDI). The retinal nerve fiber layers thickness and vascular densities were compared between groups in both macula and optic disc. The correlations between vascular density and clinical features were also determined. Statistical significance was defined as p < 0.05. Results: The study included 52 eyes, 28 in the insulin CSII group. The mean age was 36.66 ± 12.97 years, with no difference between groups ( p = 0.49). The mean glycated hemoglobin (HbA1c) was found to be lower in the CSII group (7.1% ± 0.7 vs 7.5% ± 0.7 p < 0.01). The parafoveal vascular density was found to be higher in the CSII group (42.5% ± 0.4 vs 37.7% ± 0.6, p < 0.01). We found an inverse correlation between HbA1c value and parafoveal vascular densities ( p < 0.01, r = −0.50). Conclusion: We found that CSII provided better metabolic control than MDI and this seemed to result in higher parafoveal vascular density. As lower vascular density is associated with an increased risk of diabetic retinopathy, these results suggest that CSII could be the safest therapeutic option to prevent retinopathy.

scholarly journals Outcomes of Local Bone Graft and Fixation of Proximal Pole Scaphoid Nascent Nonunions and Nonunions

2020 ◽  
Vol 09 (03) ◽  
pp. 203-208
Author(s):  
Kristin E. Shoji ◽  
F. Joseph Simeone ◽  
Sezai Ozkan ◽  
Chaitanya S. Mudgal
Keyword(s):  
Bone Graft ◽  
Common Mechanism ◽  
Study Cohort ◽  
Proximal Pole ◽  
Scaphoid Fractures ◽  
Local Bone ◽  
Case Series Study ◽  
Increased Risk ◽  
Surgical Fixation ◽  
The Mean

Abstract Background Fractures of the proximal pole of the scaphoid have an increased risk of nonunion due to its tenuous blood supply. The optimal treatment of proximal pole scaphoid nonunions remains controversial. Objectives To review a single surgeon's experience with proximal pole scaphoid nascent nonunions (delayed unions) and nonunions that underwent surgical fixation with a cannulated headless compression screw and local autologous bone graft from the distal radius. Patients and Methods After obtaining Institutional Review Board approval, the electronic medical record of one tertiary care center was queried for patients with the diagnosis of “proximal pole scaphoid fractures” who underwent surgical fixation by a single surgeon over an 11-year period (2006–2017). Fifteen patients met initial query criteria; upon review of records, four patients were excluded due to the acute nature of the fracture, and one was excluded as surgical fixation included a vascularized bone graft. Results The final study cohort consisted of 10 patients with a total of 10 proximal pole scaphoid nonunions. Almost all of the patients in this study were male (9/10 [90%]), and sporting activities were the most common mechanism of injury (8/10 [80%]). Volumetric measurements of the scaphoid fractures on computed tomography (CT) revealed that the mean total volume of the scaphoid was 2.4 ± 0.48 cm3 and the mean volume of the proximal pole fragment was 0.38 ± 0.15 cm3. Postoperative CT scans were performed at a mean of 12.4 weeks (range: 8–16 weeks), with seven (7/10 [70%]) showing signs of complete union and three (3/10 [30%]) demonstrating partial union. None of the patients required additional procedures and there were no complications. Conclusions Our results suggest that proximal pole scaphoid fractures with delayed union and nonunion treated with surgical fixation and autologous local bone graft heal without the need for more complex vascularized procedures. The volume of the proximal pole fragment did not correlate with increased risk of ongoing nonunion after the index procedure. Level of Evidence This is a Level IV, case series study.

Sign in / Sign up

Export Citation Format

Share Document